Mentally Ill Patients Could Lose Drug Access

February 6, 2004|By Bob LaMendola Health Writer

An estimated 1,000 mentally ill indigent people could be cut off from their medications because the tax-assisted North Broward Hospital District will stop supplying certain patients at its primary care clinics as of March 1.

Without drugs to control their behavior, many of those people will likely be jailed or hospitalized, mental health advocates said at a Thursday brainstorming session. They asked the district to extend the deadline so they could find a stopgap solution.

"This is very frightening as a provider and as a community," said Dr. Francine Carattini, a psychiatrist who works part time for the district and for several mental health programs.

Those affected include people getting out of Broward County jails, addiction treatment programs and homeless centers, plus hundreds in community programs such as the Henderson Mental Health Center.

"We're going to be running around Baker Acting people left and right," said Officer Scott Russell, coordinator of crisis intervention and homeless issues for the Fort Lauderdale police department, referring to the state act that allows officials to detain mentally ill people deemed to be a danger to themselves or others.

Hospital officials said they are not unsympathetic to the problem, but contended that the state and other agencies have foisted their uninsured mentally ill patients upon the district's busy clinics, which were not set up for psychiatric care.

Doctors at mental health programs have long sent indigent patients to district clinics with prescriptions to fill, and the clinic pharmacy or doctor would go along, said Jasmin Shirley, a district vice president who oversees the clinics. The district collects $164 million a year in taxes to pay for medical care of the uninsured at its four hospitals and two dozen clinics.

Shirley said a budget review found the clinics' cost is unclear but at least $1 million a year. With the drugs becoming more expensive and the clinics losing money, Shirley said the district decided to enforce its original policy of supplying the drugs only to its own patients

"It looks like we have been dumped on. Enough. Enough. We're not the mental health provider for Broward County," Shirley said. "We can only do so much. Somewhere along the way, you have made our center a retail pharmacy. It is not. It cannot operate like that."

Broward County pays the district $7 million to provide primary health care to the uninsured, but Shirley said the clinics cost more like $20 million. Hospital officials hope to win more money from the county when the contract comes up for renewal Sept. 30, but mental health advocates said their patients cannot wait that long without the medications.

"The psychiatric services program is pretty much meaningless if you give them a prescription and they can't get it filled," said Dr. Bhagirathy Sahasranaman, medical director at Henderson.

The big problem is that no one is taking responsibility for the indigent mentally ill, said John DeGroot of the Broward Sheriff's Office.

Bob LaMendola can be reached at blamendola@sun-sentinel.com or 954-356-4526.